| NPI | 1497566970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUE A WELLS Sr Dir Of Provider Services 304-597-3525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101Y00000X Counselor |
| 104100000X Social Worker | |
| Enumeration Date | 2025-01-15 |
| Last Update Date | 2025-01-15 |